复合乳酸菌联合美沙拉秦治疗溃疡性结肠炎的临床效果

Clinical effects of compound lactobacillu combined with mesalazine on ulcerative colitis

目的探讨复合乳酸菌联合美沙拉秦治疗溃疡性结肠炎的治疗效果及相关机制。方法选取160例轻度或中度活动期溃疡性结肠炎(UC)的患者,按照随机数表法将其分为两组,每组80例。实验组给予口服美沙拉嗪肠溶片联合复合乳酸菌,对照组给予口服美沙拉嗪肠溶片。于治疗后第8周对两组患者行肠镜复查;检查治疗前后患者的尿、血、粪常规及生化;检查两组患者治疗前后外周血炎性相关细胞因子变化;治疗后随访患者的相关症状及体征变化,比较观察两组患者治疗效果及治疗后不良反应及复发率。结果实验组患者治疗后总有效率、临床缓解时间及缓解率优于对照组,差异有统计学意义(P<0.05);治疗后,两组患者炎症抑制因子TGF-β及IL-4表达升高,差异有统计学意义(P<0.01),相反IL-6和TNF-α等炎症促进因子则降低(P<0.05),且实验组患者上述细胞因子水平改善程度更大(P<0.05)。治疗后两组患者中均出现不同程度不良反应,实验组不良反应和复发率优于对照组(P<0.05)。结论联合应用美沙拉嗪和复合乳酸菌的总有效率、临床症状、缓解率优于单用美沙拉嗪,且不良反应和三月复发率均明显改善,联合用药还可促进抑炎因子的表达和抑制促炎因子,是一种安全有效的治疗溃疡性结肠炎的方案,值得临床推广应用。

Objective To observe the clinical effects of compound lactobacillu combined with mesalazine on ulcerative colitis. Methods One hundred and sixty patients with mild or moderate ulcerative colitis were divided into experimental group and control group according to the random number table method,with 80 cases in each group. The patients in control group received mesalazine treatment,while the patients in the experimental group were treated with mesalazine combined with lactobacilli tablets.The clinical therapeutic effect,clinical remission rate,adverse reactions,recurrence rate and the remission time of the patients in two groups were assessed. The blood-rt,urine-rt,stool-rt of and changes of inflammation cytokines of two groups were measured. Results The total effective rate and clinical remission rate of the patients in experimental group were significantly higher than that of the control group（ P 0. 05）; the remission time was shorter than that of the control group（ P 0. 05）. The levels of TGF-β and IL-4 of patients in the two groups significantly increased after treatment,and the level inexperimental group was significantly higher than that of the control group after treatment. The levels of IL-6 and TNF-α significantly decreased after treatment in two groups,and the level in experimental group was significantly lower than that of the control group. The incidence of adverse reaction and recurrence rate of the patients in experimental group were lower than those of the control group（ P 0. 05）. Conclusions Compound lactobacillu combined with mesalazine are effective on active ulcerative colitis and preventing relapse,which had a negligible incidence of serious complications. It＇s worthy of clinical application.